NPI 1629692074 · live from the CMS NPI Registry
Nathan James Aultman, PT
Physical Therapist in Shreveport, LA. National Provider Identifier 1629692074, active.
NPI record
| NPI | 1629692074 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 1800 Buckner St Ste C249, Shreveport, LA 71101 |
| Practice phone | 318-934-1969 |
| Mailing address | Po Box 1377, West Monroe, LA 71294 |
| Enumerated | June 2, 2020 |
| Last updated | June 2, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist primary | 225100000X | 10588 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.